Utility of diffusion-weighted MR imaging in the diagnosis of placenta accreta spectrum abnormality

Sannananja, Bhagya; Ellermeier, Anna; Hippe, Daniel S.; Winter, Thomas C.; Kang, Stella K.; Lee, Susanna I.; Kilgore, Mark R.; Dighe, Manjiri

doi:10.1007/s00261-018-1599-8

Cited by 17 publications

(11 citation statements)

References 15 publications

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“…In contrast to ultrasound, MRI can provide versatile contrast that may provide additional information about the placenta structure and function to assist the diagnosis of PAS disorders. [32][33][34] Bao et al recently investigated the diagnostic value of intravoxel incoherent motion (IVIM) for PAS disorders with accreta lesions and showed that the pseudo-diffusion fraction could predict PAS disorders with an accuracy of 85.7%. 35 Sun et al used textural features and automated machine learning to identify suspicious PAS disorders based on anatomical MRI and achieved sensitivity, specificity, and accuracy of 100%, 88.5%, and 95.2%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…For example, according to a recent study, the diagnostic accuracy of ultrasound in predicting PAS disorders was 79.71% in the third trimester 16 while anatomical MRI showed an accuracy of 82%, 15 and MRI is essential for pregnant women with obesity, over‐sized fetus, and oligohydramnios. In contrast to ultrasound, MRI can provide versatile contrast that may provide additional information about the placenta structure and function to assist the diagnosis of PAS disorders 32–34 . Bao et al recently investigated the diagnostic value of intravoxel incoherent motion (IVIM) for PAS disorders with accreta lesions and showed that the pseudo‐diffusion fraction could predict PAS disorders with an accuracy of 85.7% 35 .…”

Section: Discussionmentioning

confidence: 99%

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Diffusion MRI Based Myometrium Tractography for Detection of Placenta Accreta Spectrum Disorder

Yan

Liao

et al. 2021

Magnetic Resonance Imaging

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Background Prenatal diagnosis of placenta accreta spectrum (PAS) disorders is difficult. Magnetic resonance imaging (MRI) has been shown to be a useful supplementary method to ultrasound. Purpose To investigate diffusion MRI (dMRI) based tractography as a tool for detecting PAS disorders, and to evaluate its performance compared with anatomical MRI. Study Type Prospective. Population Forty‐seven pregnant women in the third trimester with risk factors for PAS. Field Strength/Sequence Using fast imaging employing steady‐state acquisition and high‐angular resolution dMRI at 1.5 Tesla. Assessment Diagnosis of PAS was performed by three radiologists based on the dMRI‐based feature of myometrial fiber discontinuity and on commonly used anatomical features including presence of dark band, discontinuous myometrium and bladder wall interruption. We evaluated the sensitivity, specificity, accuracy, and area‐under‐the‐curve (AUC) of the individual features and established an integrated model with random forest analysis. Statistical Tests Maternal age and gestational age at scan were compared between PAS and control group using a t‐test, and childbearing history was compared using a chi‐squared test. The random forest model was employed to combine the anatomical and dMRI features with 5‐fold cross‐validation, and the weight of each feature was normalized to evaluate its importance in predicting PAS. Results Based on surgical pathology reports, 16 out of 47 patients had confirmed PAS. The anatomical feature of dark bands and tractography marker achieved the highest AUC of 0.842 for predicting PAS, and the integrated anatomical and tractography features further improved the AUC of 0.880 with an accuracy of 87.2%. The tractography feature contributed most (30.1%) to the integrated model. Data Conclusion Myometrial tractography demonstrated superior performance in detecting PAS. Moreover, the combination of dMRI‐based tractography and anatomical MRI could potentially improve the diagnosis of PAS disorders in clinical practice. Level of Evidence 2 Technical Efficacy Stage 2

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diffusion MRI Based Myometrium Tractography for Detection of Placenta Accreta Spectrum Disorder

Yan

Liao

et al. 2021

Magnetic Resonance Imaging

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“…dMRI is increasingly part of clinical MRI exams for assessing fetal brain development and injury 57,58,59 . Diffusion imaging has also been included in the assessment of invasive placentation in clinical settings 60,61 .…”

Section: Discussionmentioning

confidence: 99%

In Utero Diffusion MRI

Christiaens

Slator

Cordero‐Grande

et al. 2019

Topics in Magnetic Resonance Imaging

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“…US often the primary imaging tool for evaluating women at risk for PA, such as those presenting with placenta previa and prior cesarean or uterine surgery, whereas MRI is used to con rm US diagnosis and delineate the depth and topography of placental invasion, which may signi cantly affect maternal outcomes and in uence surgical approach [24].US may be limited in detecting more severe placental penetration, especially in assessing the extent of extrauterine involvement of the placenta.In terms of evaluating the degree of invasiveness, MRI outperforms US due to its better inherent contrast.In addition, although the lower uterine segment is the most common site of PA and can usually be evaluated with a high-frequency ultrasonic probe because of its relatively super cial location in pregnancy, other locations of PA may be more di cult to identify by US.When PA is located far from the probe, such as posterior accreta or when the patient is obese, the resolution obtained will not be as good as the former.In this case, US is di cult to identify PA. On MRI, the location of PA abnormality and the patient's body size do not affect the resolution or image quality. In contrast to ultrasound, MRI can provide versatile contrast and may provide additional information about placental structure and function to assist in the diagnosis of PA [25,26]. Sun et al [27].…”

Section: The Recently Released Society Of Abdominal Radiology and Eur...mentioning

confidence: 99%

Role of magnetic resonance imaging in the diagnosis of placenta accreta

NIU

Cui

ZHU

et al. 2022

Preprint

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Objective. To analyze the value of magnetic resonance imaging (MRI) in suspicious cases for prenatal detection of placenta accreta(PA). Materials and Methods.A total of 50 placental MRI exams performed on a 1.5T scanner were retrospectively reviewed by two radiologists in consensus.HASTE (half-fourier acquisition single shot turbo spin echo)and True-FISP (true fast imaging with steady-state precession) sequences were acquired.Findings at MRI were compared with the final diagnosis,which werre determined with clinical findings at delivery and pathological examination of specimens. Results. Of 50 pregnant women in the analysis, 33 required cesarean hysterectomy, 17 underwent cesarean delivery. MRI signs such as myometrial thinning, loss of T2 hypointense interface(loss of retroplacental clear space on US), heterogenous intraplacental sign, and intraplacental T2 dark bands were more likely to be seen in this group. In this group, the cases that were finally clinically and pathologically confirmed were 12, 16 and 22 cases of placenta accreta vera, placenta increta and placenta percreta respectively. Conclusion. MRI is particularly useful in cases where US is inconclusive and to assess the extent to which the placenta penetrates the uterine serosa and invades outward into surrounding tissues. MRI has become a routine examination for patients with suspected PA in clinical practice.

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Utility of diffusion-weighted MR imaging in the diagnosis of placenta accreta spectrum abnormality

Cited by 17 publications

References 15 publications

Diffusion MRI Based Myometrium Tractography for Detection of Placenta Accreta Spectrum Disorder

Diffusion MRI Based Myometrium Tractography for Detection of Placenta Accreta Spectrum Disorder

In Utero Diffusion MRI

Role of magnetic resonance imaging in the diagnosis of placenta accreta

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